Role of Aldosterone in Mid- and Long-Term Left Ventricular Remodelling after Acute Myocardial Infarction: The REMI Study
Authors' conclusion
Aldosterone concentration in the acute phase was associated with adverse LV remodelling in the medium term, even in the subgroup of patients with LVEF >40%, suggesting a potential role of the mineralocorticoid system in post-MI adverse remodelling. Plasma aldosterone was no longer associated with LV remodelling in the long term
Study context
- Population
- Patients with first acute ST-elevation MI (STEMI) successfully treated by primary PCI80 at 3–9-year follow-up
- Participants
- 119 patients
- Outcome
- Change in LV end-diastolic and end-systolic volume index (TTE and CMR) by post-MI plasma aldosterone
- Follow-up
- 6 months
Main finding
As reported in the abstract
Association of post-MI aldosterone with increase in LV volume indices (multivariable model) · 6-month follow-up
- Left ventricular (LV) end-diastolic volume index, TTE: β ± SE 0.113 ± 0.046
- p = 0.015
- LV end-diastolic volume index, cardiac magnetic resonance (CMR): β ± SE 0.098 ± 0.040
- p = 0.015
- LV end-systolic volume index, TTE: β ± SE 0.083 ± 0.030
- p = 0.008
- LV end-systolic volume index, CMR: β ± SE 0.064 ± 0.032
- p = 0.048
Observational data: associations, not effects.
Further findings
Baseline plasma aldosterone · 2-4 days after STEMI
- Median aldosterone level [IQR] (pg/ml)
- 23.1 [16.8; 33.1]
Patients with LV ejection fraction (LVEF) >40% (subgroup) · 6-month follow-up
- Association consistent in patients with LVEF >40%
Long-term LV remodelling · 3-9 years
- Association between baseline aldosterone and adverse LV remodelling did not persist
Original publication
Role of Aldosterone in Mid- and Long-Term Left Ventricular Remodelling after Acute Myocardial Infarction: The REMI Study. Eur J Heart Fail. Published 24 August 2023. doi:10.
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